Principal pharmacist lead for education and development at Guy’s and St Thomas’ NHS Foundation Trust and Royal Pharmaceutical Society English Pharmacy Board member, Aamer Safdar, says pharmacists must “stop being precious” about traditional pharmacy roles and embrace the skills of technicians.
Empowering pharmacy technicians is good for all of us
In 2015, Lord Carter’s review of productivity in NHS hospitals called for the pharmacy workforce to be optimised so staff could work at the top of their capabilities and undertake the activities that they are trained for. Many hospitals, faced with efficiency savings, are transforming their workforces, with traditional ways of working between pharmacy professionals gradually being phased out. For example, much of the medicines supply function is now exclusively done by pharmacy technicians.
Pharmacy technicians have a well-established role in hospital pharmacy and play a vital role in the services provided. Without fully trained pharmacy support staff, pharmacy assistants and technicians, it would be very difficult for pharmacists to find time to provide the patient-facing care required in today’s NHS.
Many pharmacy technicians are trained as accuracy-checking technicians, which means that once a prescription has been clinically assessed by the pharmacist, the labelling, assembly and checking of the medicines does not require further pharmacist involvement. There are now many dispensaries without a pharmacist as they are led by pharmacy technicians and, in some hospitals, pharmacy assistants. This enables the pharmacists to concentrate on patient-facing, and often ward-based, clinical activities where their skills are integral to patient safety.
In many hospitals, pharmacy assistants work on the wards and manage ward-level stock, transfer of medicines between wards and other medicines-related activities commensurate with their skill set. Pharmacy technicians undertake medicines reconciliation for newly admitted patients, review and order routine medications for use on the wards, assemble and check take-home medicines and provide patient counselling — all activities within the scope of their practice and skills. The General Pharmaceutical Council review of initial education and training for pharmacy technicians includes accredited checking and medicines management as part of the preregistration training.
Hospital pharmacy technicians are not limited to the supply and management of ward-based medicines. They work in manufacturing and aseptic units making bespoke medicines, total parenteral nutrition, chemotherapy and intravenous antibiotics — all of which are complex tasks that require a high level of skill. They also play an important role in leadership and management in operational areas.
Pharmacy technicians are not pharmacists and are acutely aware of their limitations. They are registered professionals in their own right; they recognise the differences in their entry qualifications and they do not possess the depth of scientific and clinical knowledge of an MPharm graduate. But this does not make them inferior; they have different skills that complement those of pharmacists. Forward-thinking pharmacy leaders recognise this and are making better use of pharmacy technicians in areas such as mental health, clinics and specialist clinical areas, as well as in financial reporting (for example, medicine spending and high-cost drugs).
The current debate on pharmacists and pharmacy technicians is about uncovering areas where there is role duplication, such as in the dispensing of medicines where both professionals are usually involved. In efficient, functioning pharmacy teams, services are focused around the patient — it doesn’t matter which professional undertakes which activity: the work is prioritised based on the best skill set available. As pharmacists, we must stop being precious about the traditional roles of pharmacists and empower pharmacy technicians to work as autonomous professionals within their training and competence. Only then will we be able to develop our roles in hospitals by attending ward rounds, independently prescribing medicines and running our own clinics.
Pharmacy technicians are an essential part of the system. I have worked with many excellent pharmacy technicians as colleagues and peers and they are keen to expand their roles and develop themselves to free up pharmacists to undertake their clinical roles.
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2018.20205289
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